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Shopping Around for Outpatient Services

Mohseni, Alex MD

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doi: 10.1097/01.EEM.0000515678.91681.1b
    outpatient services
    outpatient services:
    outpatient services

    Emergency physicians are often at the nexus of conflicting forces in health care: See lots of patients, but don't admit too many of them; order fewer tests, but don't miss anything; see patients faster, but keep them happier than ever. Balancing the need to refer patients and to keep their medical costs low is about to join this list of conflicts EPs face every day.

    Sensitivity to the costs of medical procedures is increasing rapidly, especially as the national health care reimbursement paradigm evolves to a value-based model and as more patients opt for high-deductible plans. Sooner or later, we will be confronted with a new conflict: Our hospitals generally want us to refer patients to services (such as radiology) within their own networks, but hospital networks are usually the most expensive places for patients to receive these services. Services like labs and radiology often cost several times more than those in outpatient centers across the street.

    Notwithstanding the political pressures to refer internally, you may increasingly need to consider the costs, and therefore, the accessibility, of the resources to which you are referring your patients. One of the best tools for finding accurate estimates of costs of procedures is Healthcare Bluebook. ( Using real claims data, Healthcare Bluebook has an easy-to-use system that patients, providers, and employers can use to find the fair price for a procedure and how much each provider charges on average for a procedure.

    I have found their mobile application easier to use than their website. Register as a provider using your NPI number to access their database. You can use Healthcare Bluebook during your shift to guide patients to more appropriately priced service providers or simply tell patients to download the app themselves.

    Markets with incomplete information are inefficient, and Healthcare Bluebook bridges that information gap.

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